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The Agnesian HealthCare Community Care Fund helps individuals that have little or no financial resources available to them (uninsured, underinsured, ineligible for community or government programs, lower income, and no other available funding source) and are unable to pay all or a portion of charges from Agnesian HealthCare.
Application forms are available for download below or from financial counselors at Agnesian HealthCare and the Community Care/Samaritan Health Clinic office at St. Agnes Hospital. Once a completed application is received, and eligibility requirements are met, the Community Care Fund can assist at no charge or at a discount for services that are medically necessary
For more information, call (920) 926-4455.
Summary to Financial Assistance Program (English/Spanish/Hmong)
Financial Assistance Application (English)
Financial Assistance Application (Hmong)
Financial Assistance Application (Spanish)
Financial Assistance Policy (English)
Financial Assistance Policy (Hmong)
Samaritan Health Clinic/Community Care Information
Agnesian HealthCare offers a wide array of community education programs that help to enhance the overall health and well-being of individuals and families within its service area.
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Agnesian HealthCare is Sponsored by the Congregation of Sisters of St. Agnes.
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